Family history of coronary artery disease (CAD) and heart attacks predict your risk of a heart attack more accurately than any other risk factor. Your risk of a CAD can be 3 to 6 times greater if two or more close relatives had coronary artery disease. Since exchanging one’s family is somewhat problematic, family history is an untreatable risk factor. Nevertheless, the ideal number for treatable risk factors such as high cholesterol and blood pressure may depend upon a thorough family history. For example, those with a strong family history of CAD should strive for lower cholesterol.
Do I have a family history of CAD?
A positive family history of CAD used to be identified as an early heart attack in your immediate family members, specifically, a male relative (father, brother, son) with CAD at less than 55 years old or a female relative (mother, sister, daughter) younger than 65. Studies suggest that heart attacks at ANY age in ANY relative increase your risk of having a heart attack. In fact, two cousins with a heart attack is the same as one sibling who had a heart attack over the age of 50.
Who’s in my family?
The American College of Medical Genetics recommends examining 3 generations of family members. This should include: brothers and sisters, mother, father, aunts, uncles, cousins, and grandparents. It’s important to note their age when a heart attack was diagnosed.
What else can I blame on my family?
Other medical problems in your relatives like diabetes, high blood pressure, stroke, obesity, abnormal cholesterol, and of course heart attack, are also important risk factors for CAD.
Finally, sudden, or unexpected death, especially at an early age, in family members can be a warning sign of CAD or heart rhythm problems. Be sure to tell this to your doctor as soon as possible.
What should I do if I have a positive family history?
At a minimum, have your cholesterol, blood pressure, and risk for diabetes checked. Also, obtain an electrocardiogram (ECG), and talk with your doctor about getting a complete yearly history and physical.
If I have a positive family history of heart attack, will I definitely have a heart attack?
No. However, family history of early heart disease can raise your risk nearly 600 percent. For this reason, risk factors such as abnormal cholesterol, diabetes, high blood pressure, obesity, and smoking are even more important to treat.
How do I know if I have bad genes?
Thousands of pieces of information are in your genome (the DNA in your body). The exact gene or genes that increase risk of heart attacks are not yet known. Until doctors and scientists can identify these genes, family history will continue to serve as the best indicator of inherited cardiac risk.
The next few years will be exciting ones -- doctors are closing in on “heart attack genes.” One example is a gene that can make platelets (the cells which form blood clots) “stickier” in those with elevated LDL (bad cholesterol). This relationship may explain why those with high LDL are at increased risk of thrombosis (clots forming inside coronary arteries) and heart attacks.
Who can help me obtain a thorough family history?
A basic family history is part of a complete physical examination and should be updated on a yearly basis. It's also a good idea to let your doctor know of any new illness that occurs in your family. In some cases more specialized genetic counseling is required. Your doctor may refer you to a geneticist in such cases. According to Dr. Steven Murphy, a physician with HelixHealth, specializing in cardiac genetics, “there are specialists in medicine such as geneticists and genetic counselors who are trained to take and interpret family histories.”
How do you find someone trained in medical genetics?
Below are several:
- Helix Health: New York.
- Ferre Institute: New York.
- Cedars Sinai: California.
- Joint program of NewYork-Presbyterian Hospital/Columbia University Medical Center and NewYork-Presbyterian Hospital/Weill Cornell Medical Center: New York
- Mount Sinai medical Center: New York.
Sources:
Maren T. Scheuner, Clinical Application of Genetic Risk Assessment Strategies for Coronary Artery Disease: Genotypes, Phenotypes, and Family History. Prim Care, 2004; 31(3):711-37.
Scheuner MT, Whitworth WC, McGruder H, Yoon PW, Khoury MJ., Expanding the definition of a positive family history for early-onset coronary heart disease. Genet Med. 2006 Aug;8(8):491-501.